zilebesiran (ALN-AGT) / Alnylam, Roche 
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  • ||||||||||  zilebesiran (ALN-AGT) / Alnylam, Roche
    Review, Journal:  Zilebesiran: an RNA interference agent-its need and potential to transform hypertension treatment. (Pubmed Central) -  Mar 1, 2026   
    Zilebesiran may redefine therapy in hypertension management through twice-yearly dosing that enhances adherence, ensures sustained BP control, and may reduce cardiovascular risk. Ongoing Phase III trials (ZENITH and KARDIA-3) will clarify its long-term efficacy, safety, and applicability across diverse populations, potentially establishing RNAi therapeutics as a new frontier in chronic hypertension treatment.
  • ||||||||||  lorundrostat (MT-4129) / Mineralys Therap, zilebesiran (ALN-AGT) / Alnylam, Roche, baxdrostat (CIN-107) / AstraZeneca
    Journal:  New pharmacological therapies for hypertension. (Pubmed Central) -  Jan 28, 2026   
    ASI therapies lorundrostat and baxdrostat are close to being licensed for HTN. Once commercially available and recommended in treatment guidelines, the next big challenge will be reimbursement and implementation model in different healthcare systems.
  • ||||||||||  zilebesiran (ALN-AGT) / Alnylam, Roche
    Review, Journal:  A New Avenue for the Long-Term Upstream Inhibition of the Renin-Angiotensin-Aldosterone System by Inhibiting Angiotensinogen RNA. (Pubmed Central) -  Dec 27, 2025   
    In the last fifty years different therapeutic strategies, including angiotensin converting enzyme inhibitors (ACEi), type 1 angiotensin II receptor blockers (ARBs) and angiotensin receptor neprilysin inhibitors (ARNi), have been developed to counteract this neurohormonal dysregulation. However, all these therapeutic strategies have a relatively short-term action and they need to be administered orally once or more times every day to achieve the therapeutic purposes with a risk of poor therapeutic adherence.More recently, the search for a new effective strategy to provide a long-term control of hypertension was recently boosted by the availability of novel technologies, such as the angiotensinogen suppression in the liver realized through the silencing of RNA with zilebesiran, a small interfering RNA (siRNA) agent.The purpose of this article is to review the available data on Zilebesiran and to discuss in detail potential advantages in the clinical use as well as the still unresolved potential risks.
  • ||||||||||  zilebesiran (ALN-AGT) / Alnylam, Roche
    Retrospective data, Review, Journal:  Efficacy and Safety of Zilebesiran for the Management of Hypertension: An Updated Systematic Review and Meta-Analysis of Randomised Controlled Trials. (Pubmed Central) -  Oct 20, 2025   
    However, all these therapeutic strategies have a relatively short-term action and they need to be administered orally once or more times every day to achieve the therapeutic purposes with a risk of poor therapeutic adherence.More recently, the search for a new effective strategy to provide a long-term control of hypertension was recently boosted by the availability of novel technologies, such as the angiotensinogen suppression in the liver realized through the silencing of RNA with zilebesiran, a small interfering RNA (siRNA) agent.The purpose of this article is to review the available data on Zilebesiran and to discuss in detail potential advantages in the clinical use as well as the still unresolved potential risks. This meta-analysis confirms that Zilebesiran is consistently associated with significant reductions in both ambulatory and office blood pressure over 12 to 24 weeks, with an acceptable safety
  • ||||||||||  zilebesiran (ALN-AGT) / Alnylam, Roche
    Journal:  Zilebesiran Add-On Treatment for Inadequately Controlled Hypertension-Reply. (Pubmed Central) -  Sep 24, 2025   
    Results of the KARDIA-3 trial, including patients with CKD, will characterize the efficacy and safety profile of zilebesiran in patients with uncontrolled hypertension despite standard care who are at high CV risk and will inform the design of a planned CVOT. No abstract available
  • ||||||||||  zilebesiran (ALN-AGT) / Alnylam, Roche
    Enrollment closed, Enrollment change:  A Study to Evaluate ALN-AGT01 RVR in Adult Healthy Volunteers (clinicaltrials.gov) -  Aug 26, 2025   
    P1,  N=42, Active, not recruiting, 
    Active, not recruiting --> Completed Recruiting --> Active, not recruiting | N=78 --> 42
  • ||||||||||  zilebesiran (ALN-AGT) / Alnylam, Roche
    Review, Journal:  Advancing antihypertensive drug development. (Pubmed Central) -  Jun 3, 2025   
    RNA-based therapies, like zilebesiran, provide a novel approach to suppress angiotensinogen, offering durable antihypertensive effects with less frequent dosing...These emerging therapies not only aim to lower blood pressure but also address underlying pathophysiological mechanisms, offering a precision-focussed approach to treatment. By critically analysing these developments, this review provides insights into how novel strategies can overcome existing challenges in hypertension management, reduce the global disease burden and improve patient outcomes.
  • ||||||||||  zilebesiran (ALN-AGT) / Alnylam, Roche
    Journal:  Zilebesiran: A Novel RNA Interference Therapeutic for Hypertension. (Pubmed Central) -  Jun 2, 2025   
    Therapeutic applications under investigation include use as monotherapy in patients with essential hypertension and as an adjunct for patients with resistant hypertension or high cardiovascular risk. This manuscript provides a comprehensive overview of zilebesiran's mechanism of action, pharmacokinetics/pharmacodynamics, clinical trial evidence, potential role in hypertension management and related conditions, as well as its safety and tolerability profile, based on current peer-reviewed data.
  • ||||||||||  Review, Journal:  Novel Antihypertensive Medications to Target the Renin-Angiotensin System: Mechanisms and Research. (Pubmed Central) -  May 12, 2025   
    The current overview presents the latest research findings on the mechanisms through which novel anti-hypertensive medications target the RAS. These include zilebesiran (targeting angiotensinogen), PRO20 (targeting the renin/(pro)renin/PRR axis), sacubitril/valsartan (targeting the renin/ACE/Ang II/AT1R axis), GSK2586881, Ang (1-7) and AVE0991 (targeting the renin/ACE2/Ang (1-7)/MasR axis), alamandine (targeting the alamandine/MrgD receptor axis), C21 and ?-Pro7-Ang III (targeting the renin/ACE/Ang II/AT2R axis), EC33, and firibastat and NI956 (targeting brain Ang III).
  • ||||||||||  zilebesiran (ALN-AGT) / Alnylam, Roche
    Review, Journal:  Advancing hypertension management: the role of zilebesiran as an siRNA therapeutic agent. (Pubmed Central) -  Mar 20, 2025   
    Its emergence highlights the ongoing evolution of cardiovascular pharmacology and underscores the importance of innovative approaches to address the global burden of hypertension. Moving forward, concerted efforts in research and clinical practice are necessary to realize the benefits of zilebesiran into hypertension management protocols, ultimately advancing cardiovascular health worldwide.
  • ||||||||||  zilebesiran (ALN-AGT) / Alnylam, Roche
    Retrospective data, Review, Journal:  Zilebesiran and Hypertension: A Systematic Review and Meta-analysis. (Pubmed Central) -  Jan 12, 2025   
    Optimal dosing appears between 250 and 500 mg. Further research should explore patient-specific responses to enhance therapeutic efficacy and minimize side effects.
  • ||||||||||  zilebesiran (ALN-AGT) / Alnylam, Roche
    Enrollment open:  A Study to Evaluate ALN-AGT01 RVR in Adult Healthy Volunteers (clinicaltrials.gov) -  Dec 16, 2024   
    P1,  N=78, Recruiting, 
    Active, not recruiting --> Completed Not yet recruiting --> Recruiting
  • ||||||||||  zilebesiran (ALN-AGT) / Alnylam, Roche, Tryvio (aprocitentan) / J&J, baxdrostat (CIN-107) / AstraZeneca
    Review, Journal:  Novel pharmacologic approaches in resistant hypertension. (Pubmed Central) -  Dec 11, 2024   
    Recently, valsartan/sacubitrol and flozins have been increasingly used in resistant hypertension, which have been introduced for the treatment of diseases other than hypertension but can be a supplement to previously used drugs in resistant hypertension...The results to date allow for the consideration of aprocitentan (a drug that inhibits endothelin receptors) or baxdrostat or another new aldosterone synthesis inhibitor in the treatment of resistant hypertension that does not respond to 4 drugs, including spironolactone. Further studies are needed to confirm the efficacy and safety of these new drugs in the treatment of resistant hypertension.
  • ||||||||||  zilebesiran (ALN-AGT) / Alnylam, Roche
    Review, Journal:  Will zilebesiran, an RNA interference therapy, be effective, safe, and improve the treatment of hypertension? (Pubmed Central) -  Dec 4, 2024   
    It was also difficult to reliably interpret the results of KARDIA-1 as blood pressure went up significantly in the placebo group. KARDIA-1 did not answer previous concerns about zilebesiran; (i) what happens during volume depletion, sepsis, and pregnancy when angiotensinogen is inhibited long-term or (ii) will it be effective in a high sodium diet.
  • ||||||||||  Journal:  Options for patients with out-of-control blood pressure: after all avenues have been exhausted. (Pubmed Central) -  Sep 11, 2024   
    Comorbid conditions should be treated as appropriate with sodium-glucose-cotransporter 2 inhibitors, glucagon-like peptide-1 receptor agonists, sacubitril-valsartan or finerenone...The endothelin antagonist aprocitentan may be a final option in some countries. Of the drugs in development, the RNA based therapeutics that inhibit angiotensinogen synthesis appear to be some of the most promising.
  • ||||||||||  Review, Journal:  RNA interference therapy in cardiology: will new targets improve therapeutic goals? (Pubmed Central) -  Aug 27, 2024   
    Zilebesiran, which targets hepatic angiotensinogen mRNA, has demonstrated a dose-related reduction in serum angiotensinogen levels, thereby lowering blood pressure in patients with systemic arterial hypertension...In the future, larger studies will provide insights into improvements in cardiovascular outcomes, long-term safety and broader applications in the general population. This review highlights the historical timeline of the development of siRNA-based drugs, their clinical indications, potential side-effects and future perspectives.
  • ||||||||||  zilebesiran (ALN-AGT) / Alnylam, Roche
    Journal:  Clinical experience of Tianxiong Granules in treatment of hypertension based on treatment principle of supressing Yang and promoting blood circulation (Pubmed Central) -  May 30, 2024   
    Despite continuous progress in modern medicine in the treatment of hypertension with new antihypertensive drugs such as Zilebesiran, a nucleic acid drug that acts on microRNA, direct renin inhibitors, and renal sympathetic blockade, the control rate is still not ideal...Some drugs can be used in sufficient quantities. By analyzing the compatibility of Tianxiong Granules, clinical application indications, combined formula experience, and dosage application experience, we provide effective treatment methods and more options for TCM to treat hypertension with Yang hyperactivity and blood stasis syndrome.
  • ||||||||||  zilebesiran (ALN-AGT) / Alnylam, Roche, IONIS-AGT-LRx / Ionis
    Injectable angiotensinogen inhibition therapy for hypertension: a systematic review and meta-analysis (Station 7 - Research Gateway) -  May 14, 2024 - Abstract #ESC2024ESC_4571;    
    Conclusions In this meta-analysis of RCTs, injectable AGT inhibitors were associated with a significant decrease in mean AGT, SBP, and DBP as compared with placebo. There were no significant differences between groups in serious adverse events, although injection site reaction was more common in patients treated with injectable AGT inhibitors.
  • ||||||||||  Review, Journal:  Highlights of Cardiovascular Disease Prevention Studies Presented at the 2023 American Heart Association Scientific Sessions. (Pubmed Central) -  Mar 5, 2024   
    Included studies assessed semaglutide and cardiovascular outcomes in overweight or obese patients without diabetes (SELECT); dapagliflozin in patients with acute myocardial infarction without diabetes (DAPA-MI); effects of dietary sodium on systolic blood pressure in middle-aged individuals (CARDIA-SSBP); long-term blood pressure control after hypertensive pregnancy with physician guided self-management (POP-HT); effect and safety of zilebesiran, an RNA interference therapy, for sustained blood pressure reduction (KARDIA-1); recaticimab add-on therapy in patients with non-familial hypercholesterolemia and mixed hyperlipidemia (REMAIN-2); efficacy and safety of lepodisiran an extended duration short-interfering RNA targeting lipoprotein(a); safety and pharmacodynamic effects of an investigational DNA base editing medicine that inactivates the PCSK9 gene and lowers LDL cholesterol (VERVE-101); automated referral to centralized pharmacy services for evidence-based statin initiation in high-risk patients; and effects of intensive blood pressure lowering in reducing risk of cardiovascular events (ESPRIT). Research presented at the 2023 AHA Scientific Sessions emphasized innovative strategies in cardiovascular disease prevention and management.
  • ||||||||||  zilebesiran (ALN-AGT) / Alnylam, Roche
    Review, Journal:  KEY HYPERTENSION BREAKTHROUGHS AND EMERGING TRENDS FROM THE AHA SCIENTIFIC SESSIONS. (Pubmed Central) -  Mar 4, 2024   
    Furthermore, the KARDIA-1 study introduces us to Zilebesiran, an innovative RNA interference drug...The IMPACTS trial and the "Hypertension Treatment in Nigeria Program" demonstrate the effectiveness of implementing comprehensive blood pressure control strategies in real-world settings. These studies highlight the feasibility and scalability of such interventions, especially in low-resource environments, and their potential to significantly improve public health outcomes.